Evidence map›Paper›PMID 39651850›Full record

Trial reportClinical pharmacology and therapeutics2025

Safety, Pharmacokinetics, and Pharmacodynamics of a First-in-Class ClC-1 Inhibitor to Enhance Muscle Excitability: Phase I Randomized Controlled Trial.

Titia Q Ruijs, Catherine M K E de Cuba, Jules A A C Heuberger, John Hutchison, Jane Bold, Thomas S Grønnebæk, Klaus G Jensen, Eva Chin, Jorge A Quiroz, Thomas K Petersen and 10 more

Abstract readRandomized Controlled TrialClinical Trial, Phase I
In one paragraph

Trial report in Clinical pharmacology and therapeutics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. The Neuromuscular Junction: A Shared Vulnerability in Aging and Disease.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2025
    Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Titia Q RuijsCentre for Human Drug Research, Leiden, The Netherlands.ORCID 0000-0002-8261-924X
Catherine M K E de CubaCentre for Human Drug Research, Leiden, The Netherlands.ORCID 0009-0007-2998-708X
Jules A A C HeubergerCentre for Human Drug Research, Leiden, The Netherlands.ORCID 0000-0001-7202-5088
John HutchisonNMD Pharma A/S, Aarhus N, Denmark.
Jane BoldNMD Pharma A/S, Aarhus N, Denmark.
Thomas S GrønnebækNMD Pharma A/S, Aarhus N, Denmark.
Klaus G JensenNMD Pharma A/S, Aarhus N, Denmark.
Eva ChinNMD Pharma A/S, Aarhus N, Denmark.
Jorge A QuirozNMD Pharma A/S, Aarhus N, Denmark.ORCID 0000-0001-8510-5722
Thomas K PetersenNMD Pharma A/S, Aarhus N, Denmark.ORCID 0009-0003-2552-1312
Peter FlagstadNMD Pharma A/S, Aarhus N, Denmark.
Marieke L de KamCentre for Human Drug Research, Leiden, The Netherlands.
Michiel J van EsdonkCentre for Human Drug Research, Leiden, The Netherlands.ORCID 0000-0001-8159-0273
Erica KlaassenCentre for Human Drug Research, Leiden, The Netherlands.ORCID 0000-0003-0089-1846
Robert J DollCentre for Human Drug Research, Leiden, The Netherlands.ORCID 0000-0002-7551-9072
Ingrid W KoopmansCentre for Human Drug Research, Leiden, The Netherlands.ORCID 0000-0003-4199-9781
Annika A de GoedeCentre for Human Drug Research, Leiden, The Netherlands.ORCID 0000-0002-1549-6753
Linda B S AulinCentre for Human Drug Research, Leiden, The Netherlands.ORCID 0000-0003-4840-5704
Thomas H PedersenNMD Pharma A/S, Aarhus N, Denmark.ORCID 0000-0002-1060-4989
Geert Jan GroeneveldCentre for Human Drug Research, Leiden, The Netherlands.ORCID 0000-0002-4655-6667

Funding

NMD Pharma A/S
6 · The paper itself

Abstract

NMD670 is a first-in-class inhibitor of skeletal muscle-specific chloride channel ClC-1, developed to improve muscle weakness and fatigue in neuromuscular diseases. Preclinical studies show that ClC-1 inhibition enhances muscle excitability, improving muscle contractility and strength. We describe the first-in-human, randomized, double-blind, placebo-controlled study, which evaluated the safety, pharmacokinetics, and pharmacodynamics of single and multiple doses of NMD670 in healthy male and female subjects. Single-ascending doses (50-1,600 mg) were administered in a (partial) cross-over design; multiple-ascending doses (200-600 mg q.d.; 400 mg b.i.d.) were administered in a parallel design. Differences in pharmacokinetics between males/females and fed/fasted states were evaluated. Pharmacodynamic effects were evaluated using muscle velocity recovery cycles (MVRC) and analyzed using mixed-effects modeling. NMD670 was generally safe and well-tolerated in healthy subjects, with the only dose-related adverse event being myotonia occurring at the highest dose levels tested (single dose of 1,200, and 1,600 mg). Moreover, NMD670 significantly increased the following MVRC parameters after a single dose of 1,200 mg compared with placebo: early supernormality (estimated difference (ED) 2.04; 95% confidence interval (CI) 0.379, 3.70; P = 0.0242); early supernormality after 5 conditioning stimuli (ED 2.51; 95%CI 0.599, 4.41; P = 0.0177); supernormality at 20 ms (ED 2.78; 95%CI 1.377, 4.181; P = 0.0021). Importantly, the results of this study indicate pharmacological target engagement at well-tolerated dose levels in healthy subjects; firstly, because myotonia was an expected exaggerated on-target pharmacological effect, and secondly, because the effects on MVRC indicate increased muscle cell excitability. This study in healthy subjects indicates proof-of-mechanism and provides a solid base for translation to patients with neuromuscular diseases.

Indexed as

Chloride ChannelsMuscle, SkeletalAdolescentAdultCross-Over StudiesDose-Response Relationship, DrugDouble-Blind MethodFemaleHumansMaleMiddle AgedMuscle ContractionYoung AdultChloride ChannelsCLC-1 channel

Identifiers

PMID39651850
PMCPMC11835425

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.